Headset for fixation of facial fractures



R. B. MATHUES 2,681,058

June 15, 1954 Filed Jan. 5, 1951 l4 Hg Fig.3 62

HVVENTOR. RALPH B. MATHUES ATTORNEY June 15, 1954 R. B. MATHUES HEADSET FOR FIXATION OF FACIAL FRACTURES 2 Sheets-Sheet 2 Filed Jan. 5, 1951 R. m% mu VH m A M 8 1 QHV T ATToEA/EY 'Patented June 15, 1954 UNITED STATE ATENT OFFICE HEADSET FOR FIXA'EION F FACIAL FRACTURES 6 Claims.

This invention relates to a new and improved head set for fixation of complicated facial fractures, and the principal object of the invention resides in the provision of a rigid but adjustable device of this nature which is wholly fixed once it is set in position and does not depend upon resilient wires, springs, etc., as has been the practice in the past.

To this end, the invention comprises in general a head band to be set upon the head to form a fixed support, preferably in a plaster or plastic bandage, and having a series of brackets thereon which selectively receive and support a track extending generally outwardly and away from the band but angularly adjustable with respect thereto, there being an upright post mounted on the track, said post being axially adjustable and having at one end thereof a universal attachment for the securement thereto of a bone screw or 2. Roger Anderson pin or the like, together with means for positively moving the block along the track so that when the bone screw has been applied where desired, it may be clamped to the universal device and the post may then be firmly and positively traveled in either direction to apply exactly the desired amount of traction to the fracture and to thereafter positively and definitely hold the same against any motion whatsoever, this resulting in much faster setting or union taking place.

Further objects reside in the invention of a device of the class described which is extremely flexible in application and adaptable but at the same time is relatively simple in construction, use, and application, and provides a definitely rigid external fixation so that union takes place in the least possible time, particularly in fractures of the zygoma, mandible and maxilla.

Other objects and advantages of the invention will appear hereinafter.

Reference is to be had to the accompanying drawings in which Fig. 1 is a perspective view of the device illustrating its application to a fracture of the maxilla;

Fig. 2 is a view in side elevation thereof on an enlarged scale, parts being in section;

Fig. 3 is a section on line 3-3 of Fig. 2, parts being removed;

Fig. 4 is a plan view of the arch bar;

Fig. 5 is a view in elevation illustrating the device in use for a fracture of the mandible;

Fig. 6 shows the device in position where it is in use for a fracture of the zygoma;

Fig. '7 is a detailed view illustrating the post holding block;

Fig. 8 is an illustration of a modification;

Fig. 9 is a detailed view illustrating the manner of clamping a bone pin or screw;

Fig. 10 is a section on line Ill-It of Fig. 9; and

Figs. 11 and 12 illustrate the top and bottom of a bone pin plate.

Fig. 13 is an illustration of a pin holding block.

In the present case there is illustrated an adjustable head band H] which is adapted to l oe set in a plastic or plaster bandage. The head band is placed on the head as straight as possible, but, of course, it is clear that although it may be set fairly evenly, it is impossible to set the band exactly as may be desired for the particular fracture to be treated, as will appear more fully hereinafter. The head band is provided with a series of channel shaped brackets l2 located at strategic positions, these brackets receiving and supporting arms l4 which comprise a double track as clearly shown in Figs. 1 and 3. A block it at one end of the arms [4 is mounted on the bracket by means of a vertical pivot pin 18 for horizontal swinging movement of the track on a vertical axis, and a pin 19 secures arms M to the block. A block 20 at the other end of the arm is threadedly engaged with a threaded rod 22 having a thumb screw head 24 for rotation thereof.

A block 26 is engaged with the arms is for slidable movement therealeng under the influence of the screw rod 22 which extends therethrough and may be rotatably mounted with respect thereto by washers 28 which may be of the locking type. The block 28 is vertically bored for the sliding reception of a vertical hollow post 30 having an elongated slot 32 to accommodate the screw rod 22, see Fig. 3. Post 30 is threaded at each end as at 34 and each threaded portion is provided with a nut 36 clamping between them loose sleeves 38 which in turn provide for clamping post 39 in vertically adjusted position relative to the block 26.

At its lower end post 30 is provided with a nut 48 containing a collet 42 for adjustably clamping a telescoping rod 44 for adjustment axially of the hollow post. At its lower end rod 44 is provided with a ball 46 to universally mount a plate as having a clamping plate 59 associated therewith. Plates :is and 50 are clamped on ball as in any desired angular relation thereto by means of the screw clamp 52. Screws 54 act to maintain the two plates together and in assembled relation with the ball 46 regardless of the actuation of the screw 52.

The plate 48 is adapted to support an arch bar or wire 56, the latter having pins 58 for wiring the same to the maxilla. The arch bar is mounted on a plate 60 having an offset at 62 to allow the upper lip of the patient to come into natural contact with the lower lip, for feeding purposes, and plate 60 is attached to plate 43 as by means of a clamping screw 54 or the like.

Where a posterior mandibular segment must be held down and fixed in position, a different attachment is used on plate 48 and this attachment is shown in Figs. 9 and i0. Plate 63 is provided with a depression at in which plate 80 fits but upon removing the latter, a V-block 58 may be inserted to cooperate with a V-pierced pin ill to hold a Roger Anderson pin or other bone screw 12. The pin 10 is threaded at one end and provided with a nut 14 to clamp the parts in position.

A conventional bone screw may be clamped by a relatively simple clamping plate '55, W 5. The Roger Anderson pin may be used case of Zygoma fractures or the post at l provided with an eye it for the attachmen wire t l which is directly attached to the zyg fracture 82 in Fig. 8. Fig. 6 shows the position for applying traction to a zygoma fracture by means of the Roger Anderson pin or the like. Plate 68 may have various angular groves 8 in either surface thereof to position the bone screw where desired.

The application of the device is as follows:

The patient having been given a short haircut, a snug fitting stockinette cap is placed on the head and strips of felt are held in place with adhesive tape on the stockinette cap at strategic positions to relieve the pressure of the plaster of Faris. The plaster of Paris is applied so that it is just thick and strong enough to support the head band which is placed on the head as straight as possible.

The vertical post is now adjusted so that it conforms with the dimensions of the patients face, i. e., by Vertical adjustment of the rod M or sleeves 3 3. The arch bar is made to fit the curve of the patients labial arch and is wired in place to the teeth or the bone structure, and then plate as is secured to the universal plate M3. With everything in place, the screw rod 22 is rotated so as to retract or advance block 255 just sufficiently to reduce the fracture and fix it in position. This results in an absolutely rigid construction which cannot be easily disturbed or accidentally displaced.

For mandibular fractures, the head gear is applied in much the same Way, but the bone screw is placed before application of the head gear which is then applied to come up to the bone screw. However, the traction is applied by means of the screw threaded rod 22 and nut 3% in much the same way.

In the case of zygomatic fractures, the technique is substantially the same, depending upon the type of fracture and its position.

It will be seen that the present invention has many advantages over the old methods of bendin wires and usin springs to apply traction. It is simpler and quicker to apply, more stable and rigid, and may be adjusted before and after it is in place. Also, by the thumb screw adjustment, a gradual fully controlled pressure is brought to bear on the displaced segment in any desired direction. It has the advantage over the pinslreletal method of fixing fractures because it requires the use of only one bone screw and consequently only one puncture wound is necessary. Also, since the screw is usually tapered, it is Withdrawn after the fracture is healed by the administration of a sedative only.

Having thus described my invention and the advantages thereof, I do not wish to be limited to the details herein disclosed otherwise than as set forth in the claims, but what I claim is:

l. A head set for fixation of facial fractures comprising a head band, a plurality of brackets thereon, a track, means to selectively attach the track to any one bracket, means providing for angular adjustment of the track on its selected bracket, a block slidingly engaged with the track, a hollow post passing through the block at a general right angle to the track, means to clamp the post to the block in axially adjusted position with respect thereto; a collet at one end of the post, a telescopin rod adjustably secured by the collet, a plate, a universal joint between the plate and telescoping rod, means to clamp the plate in adjusted position, means to detachably and firmly secure a bone screw or the like to the plate, said post having a transverse elongated central slot and the block having a bore therein parallel to the track, a rotatable threaded rod extending through the bore and slot, means forming a reaction point for the threaded rod, and means engaging the rod with the block for translation of the latter upon rotation of the threaded rod.

2. Head set for fixation of facial fractures com prising a band adapted to fit the upper part of the patients head and forming a fixed support, a bracket on the band-an arm pivotable on the bracket on a generally vertical axis, a track on the arm, a block on the track, means to move the block along the track toward and from the head, a post on the block for movement therewith, means to adjust the post vertically, an adjustable plate on the post remote from the arm, means to clamp the plate in adjusted position, separable means on the plate to be fixed to a facial bone element, and clamping means to detachably secure the separable means to the plate.

3. The head set of claim 2 including a universal joint for substantially universally adjusting the plate relative to the post.

i. The head set of claim 2 wherein the post is hollow and includes a rod telescopically received therein, the plate being mounted on the end of the rod.

5. The head set of claim 2 wherein the post is threaded, a pair of loose sleeves on the post one at each side of the block and adapted to bear thereon, and a nut on the threads or the post for each sleeve to clamp the block therebetween.

6. The head set of claim 2 wherein said block.

moving means comprises a rotatable threaded rod, means formin a reaction point therefor, said threaded rod engaging the block.

References Cited in the file of this patent UNITED STATES PATENTS Number Name Date 2,151,458 Allen Mar. 21, 1939 2,371,197 Taylor Mar. 13, 1945 2,372,866 Tofflemire Apr. 3, 1945 2,453,934 Preston Nov. 16, 1948 

